Individual provider Active NPI

Jessica Lynn Nishikawa, DNP, FNP-BC

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1780646695
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-1322 Issued in HI
Practice address
888 S King St
Honolulu, HI 96813-3097
Phone
(808) 522-4000
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00154976 WA
Family Nurse Practitioner 363LF0000X AP30007296 WA
Family Nurse Practitioner 363LF0000X APRN-1322 HI Primary

Addresses

Primary practice location

888 S King St
Honolulu, HI 96813-3097

Mailing address

105 Ohana St
Kailua, HI 96734-2351
Phone (509) 432-9641

Other names 1

  • Ms. Jessica Lynn Hayden, Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110802000487 HI Practitioner - Nurse Practitioner 8729082235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN00154976WAMDRegistered Nurse
APRN-1322HIMDFamily Nurse Practitioner
AP30007296WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Aug 26, 2016 Accepting new patients
Straub Clinic & Hospital CurrentSince Aug 26, 2016 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

846 S Hotel St
Ste 102
Honolulu, HI 96813
Phone (808) 532-3159

1946 Young St
Ste 320
Honolulu, HI 96826

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1780646695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 OHANA ST",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342351",
            "telephone_number": "509-432-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133097",
            "telephone_number": "808-522-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIKAWA",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00154976",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007296",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-1322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HAYDEN, JOHNSON",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.